Kristin Marie Jerome Clark, PA-C
Physician Assistant in Woodbridge, VA. Individual provider (NPI-1).
NPI number1528291069
StatusActive
Last updated in NPPESApr 6, 2016
Details
- NPI
- 1528291069
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kristin Marie Jerome Clark
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 1, 2009
- Last updated
- Apr 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0110003441 | VA | Yes |
Practice location
14010 Smoketown Rd Ste 117Woodbridge, VA 22192-4704
Phone 718-920-6656
Mailing address
14010 Smoketown RdWoodbridge, VA 22192-4722
Phone 201-669-8040
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All 49 Physician Assistant providers in Woodbridge · All 3,608 providers in Woodbridge
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